UNASSIGNED: Ten-year (2013-2023) retrospective analysis of all consecutive patients with RIP treated with HBOT at Centro de Medicina Subaquática e Hiperbárica (CMSH) (Armed Forces Hospital - Lisbon, Portugal). Patients were exposed to 100% oxygen at 2.5 ATA, in a multiplace first-class hyperbaric chamber, for 70-min periods, once daily, five times per week. Fisher\'s exact test was performed using SPSS (version 23.0); p<0.05 was accepted as statistically significant.
UNASSIGNED: Of a total of 151 patients with RIP, 88 were included in the final analysis, of whom 38.6% evidenced other concurrent radiation-induced soft tissue lesions. The most reported primary pelvic tumor treated with RT was prostate cancer (77.3%), followed by cervical cancer (10.2%). Hematochezia was the most observed clinical manifestation (86.4%). After a median of 60 HBOT sessions (interquartile range [IQR]: 40-87.5), 62.5% and 31.8% of patients achieved a clinical complete and partial response, respectively, with a hematochezia resolution rate of 93.7% (complete or partial). While partial and complete responses require fewer than 70 sessions of HBOT in terms of overall RIP symptoms (p=0.069), isolated hematochezia tends to require at least 70 sessions (p=0.075). Individuals with at least two concurrent late radiation tissue injuries were associated with a complete response to HBOT (p=0.029). Only about 5.7% of patients did not respond to the treatment. Eighteen patients (20.5%) developed reversible ear barotrauma. The number of HBOT sessions was a predictor of HBOT side effects (odds ratio: 1.010; 95% confidence interval, 1.000-1.020; p=0.047).
UNASSIGNED: The HBOT proved to be an effective and safe treatment for RIP refractory to medical and/or endoscopic treatments. This real-world evidence study adds value to published data on the management of RIP with HBOT.
■10年(2013-2023年)回顾性分析所有在美国医学中心(CMSH)接受HBOT治疗的RIP连续患者(武装部队医院-里斯本,葡萄牙)。患者在2.5ATA下暴露于100%氧气,在多地一级高压舱中,70分钟,每天一次,每周五次。使用SPSS(23.0版)进行Fisher精确检验;p<0.05被认为具有统计学意义。
■在总共151名RIP患者中,88人被纳入最终分析,其中38.6%的人同时出现其他辐射引起的软组织病变。接受RT治疗的最多报告的原发性盆腔肿瘤是前列腺癌(77.3%),其次是宫颈癌(10.2%)。便血是最常见的临床表现(86.4%)。经过60个HBOT会话的中位数(四分位数范围[IQR]:40-87.5),62.5%和31.8%的患者实现了临床完全和部分缓解,分别,便血消退率为93.7%(完全或部分)。虽然部分和完全反应需要少于70个疗程的HBOT在整体RIP症状方面(p=0.069),孤立性便血倾向于至少需要70个疗程(p=0.075)。患有至少两次并发晚期放射组织损伤的个体与对HBOT的完全反应相关(p=0.029)。只有约5.7%的患者对治疗没有反应。18例患者(20.5%)发生了可逆性耳气压伤。HBOT会话的数量是HBOT副作用的预测因子(比值比:1.010;95%置信区间,1.000-1.020;p=0.047)。
■HBOT被证明是对医学和/或内窥镜治疗难治性RIP的有效且安全的治疗方法。这项真实世界的证据研究为使用HBOT管理RIP的已发布数据增加了价值。